WILLIAM M. KELLY M.D., INC. (NPI# 1497069660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497069660 |
| Entity Type | Organization |
| Organization Name | WILLIAM M. KELLY M.D., INC. |
| Other Organization Name | HEALTH SCAN IMAGING |
| Practice Address |
425 Diamond Dr Suite 103 Lake Elsinore CA 92530-4495 |
| Mailing Address |
44489 Town Center Way Suite D Box 540 Palm Desert CA 92260-2723 |
| Practice Telephone | 9512452700 |
| Practice Fax Number | 9512452770 |
| Mailing Telephone | 7607769777 |
| Mailing Fax Number | 7607764999 |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-08-04 |
| Authorized Official Name | DR. WILLIAM M. KELLY (PRESIDENT) |
| Authorized Official Telephone | 7607768001 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | WILLIAM M. KELLY M.D., INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
A34125 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Health Scan Imaging | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306078225 | William M. Kelly M.d., Inc. | Radiology | 72980 Fred Waring Dr, Suite A, Palm Desert, CA 92260-2898 | 2009-08-11 |
| 1891969960 | William M. Kelly M.d., Inc. | Radiology | 31565 Rancho Puebla Rd, Suite 101, Temecula, CA 92592-4839 | 2008-04-18 |
| 1235203316 | William M. Kelly M.d., Inc. | Radiology | 8710 Monroe Court, Suite 100, Rancho Cucamonga, CA 91730-4883 | 2006-11-20 |
| 1922172550 | William M. Kelly M.d., Inc. | Radiology | 1080 N. Indian Canyon Dr., Suite 104, Palm Springs, CA 92262-4869 | 2006-11-17 |
| 1396816047 | William M. Kelly M.d., Inc. | Radiology | 29798 Haun Rd., Suite 103, Sun City, CA 92586-6541 | 2006-11-13 |
| 1922082767 | William M. Kelly M.d., Inc. | Radiology | 72980 Fred Waring Dr., Ste. A, Palm Desert, CA 92260-9339 | 2005-12-05 |
| 1295718161 | William M. Kelly M.d., Inc. | Radiology | 11360 Mountain View Ave, Suite C, Loma Linda, CA 92354-3861 | 2005-11-23 |
| 1700868338 | William M. Kelly M.d., Inc. | Radiology | 40700 California Oaks Rd, Ste 103, Murrieta, CA 92562 | 2005-11-18 |
| 1437149267 | William M. Kelly M.d., Inc. | Radiology | 74000 Country Club Dr, Suite E 1, Palm Desert, CA 92260-2789 | 2005-10-24 |
| Street Address |
425 DIAMOND DR SUITE 103 |
| City | LAKE ELSINORE |
| State | CA |
| Zip Code | 92530-4495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396737110 | Peggy Elizabeth Dixon Mcgill | Nurse Practitioner | 425 Diamond Dr, Lake Elsinore, CA 92530-4495 | 2005-08-17 |
| 1497216824 | Megan Renee Hall | Physician Assistant | 425 Diamond Dr, Lake Elsinore, CA 92530-4495 | 2019-03-28 |
| 1942747951 | Rochelle Bui | Physician Assistant | 425 Diamond Dr, Suite #105, Lake Elsinore, CA 92530-4495 | 2017-01-28 |
| 1639594955 | Total Care Family Medical Center of Lake Elsinore Inc | Non-Pharmacy Dispensing Site | 425 Diamond Dr, Suite 102, Lake Elsinore, CA 92530-4495 | 2014-02-24 |
| 1932524501 | Roslyn Richardson | Nurse Practitioner | 425 Diamond Dr, Lake Elsinore, CA 92530-4495 | 2014-02-19 |
| 1538499470 | Shafi Ullah Siddiqi | General Practice | 425 Diamond Dr, Ste 102, Lake Elsinore, CA 92530-4495 | 2009-12-27 |
| 1679737795 | Linda Marie Evans | Physical Therapist | 425 Diamond Dr, Ste. 101, Lake Elsinore, CA 92530-4495 | 2008-07-17 |
| 1700059995 | Farid Saadat Md Inc | Internal Medicine | 425 Diamond Dr, Suite 102, Lake Elsinore, CA 92530-4561 | 2008-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1700423779 | Karrene Louise Stanard | Peer Specialist | 31764 Casino Drive, Suite 300, Lake Elsinore, CA 92530 | 2019-12-09 |
| 1972149961 | Danielle Cravalho | Student in an Organized Health Care Education/Training Program | 31964 Mission Trail, Suite B, Lake Elsinore, CA 92530 | 2019-11-25 |
| 1952825648 | R.e. Levi Dental Corporation | Dentist | 32235 Mission Trail # 8, Lake Elsinore, CA 92530 | 2017-08-03 |
| 1144760729 | Alfred Metwashla | Pharmacist | 18269 Collier Ave, Lake Elsinore, CA 92530 | 2017-03-02 |
| 1750788733 | Roxanne Martinez | Case Manager/Care Coordinator | 31764 Casino Drive, Lake Elsinore, CA 92530 | 2014-11-19 |
| 1871870907 | Bryan Tuan Tran | Pharmacist | 160 Diamond Drive, Lake Elsinore, CA 92530 | 2011-11-03 |
| 1043590821 | Katherynn Elizabeth Williams | Marriage & Family Therapist | 600 Central Ave Ste 201, Lake Elsinore, CA 92530 | 2011-08-24 |
| 1861771677 | Judy Kelly | Marriage & Family Therapist | 224 West Graham Ave, Lake Elsinore, CA 92530 | 2011-08-10 |
| 1427343813 | Patrick Chern | Pharmacist | 18287 Collier Ave., Lake Elsinore, CA 92530 | 2011-06-14 |
| Find all providers in zip 92530 | ||||
| Taxonomy Code | 2085D0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Neuroimaging |
| A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards of performance and interpretation of Magnetic Resonance Imaging (MRI / MRA) of the head, spine, and peripheral nerves, and Computed Tomography (CT) of the head and spine. Physicians are trained in the administration of contrast media and the recognition and treatment of adverse reactions to contrast media. Neuroimaging training encompasses thorough knowledge of clinical neurology, neurophysiology, neuroanatomy, neurochemistry, neuropharmacology, and dynamics of cerebrospinal fluid circulation. Physicians possess special expertise in the technical aspects and clinical applications of each of the modalities and techniques of neuroimaging. |
| Notes: Source: American Academy of Neurology, www.aan.com [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700495363 | Faculty Physicians and Surgeons of Llusm | Radiology | 1850 N Riverside Ave Ste 160, Rialto, CA 92376-8056 | 2020-07-29 |
| 1467980631 | Valley Nerological Services, LLC | Radiology | 5260 Wilbur Ave Ste 207, Tarzana, CA 91356 | 2017-05-31 |
| 1104249291 | Neurography Institute Global Consulting Inc | Radiology | 2716 Ocean Park Blvd Ste 3082, Santa Monica, CA 90405-5266 | 2014-01-27 |
| 1306078225 | William M. Kelly M.d., Inc. | Radiology | 72980 Fred Waring Dr, Suite A, Palm Desert, CA 92260-2898 | 2009-08-11 |
| 1215164934 | Linemed Health Services Inc | Radiology | 2016 N Riverside Ave, Suite D, Rialto, CA 92377-4655 | 2009-06-20 |
| 1598916306 | Calvin Louis Rumbaugh | Radiology | 6445 Twinberry Circle, Avila Beach, CA 93424-0517 | 2008-10-10 |
| 1891969960 | William M. Kelly M.d., Inc. | Radiology | 31565 Rancho Puebla Rd, Suite 101, Temecula, CA 92592-4839 | 2008-04-18 |
| 1548473556 | Pacific Radiology, LLC | Radiology | 2209 Coffee Road, Suite M, Modesto, CA 95355 | 2007-05-07 |
| 1235203316 | William M. Kelly M.d., Inc. | Radiology | 8710 Monroe Court, Suite 100, Rancho Cucamonga, CA 91730-4883 | 2006-11-20 |
| 1922172550 | William M. Kelly M.d., Inc. | Radiology | 1080 N. Indian Canyon Dr., Suite 104, Palm Springs, CA 92262-4869 | 2006-11-17 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ELSINORE |
| Zip Code | 92530 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.